Expressive writing and wound healing in older adults: a randomized controlled trial

• Published in: Psychosomatic medicine 2013-07, Vol.75 (6), p.581-590
• Main Authors: Koschwanez, Heidi E, Kerse, Ngaire, Darragh, Margot, Jarrett, Paul, Booth, Roger J, Broadbent, Elizabeth
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biopsy; Cytokines; Depression; Doctors; Elderly people; Emotions - physiology; Female; Healing; Health psychology; Humans; Lesions; Logistic Models; Male; Middle Aged; New Zealand; Older people; Randomized controlled trials; Re-Epithelialization - physiology; Regression analysis; Stress, Psychological; Time management; Wound healing; Wound Healing - physiology; Writing
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e31829b7b2e

To investigate whether expressive writing could speed wound reepithelialization in healthy, older adults. In this randomized controlled trial, 49 healthy older adults aged 64 to 97 years were assigned to write for 20 minutes a day either about upsetting life events (Expressive Writing) or about daily activities (Time Management) for 3 consecutive days. Two weeks postwriting, 4-mm punch biopsy wounds were created on the inner, upper arm. Wounds were photographed routinely for 21 days to monitor wound reepithelialization. Perceived stress, depressive symptoms, health-related behaviors, number of doctor visits, and lipopolysaccharide-stimulated proinflammatory cytokine production were also measured throughout the study. Participants in the Expressive Writing group had a greater proportion of fully reepithelialized wounds at Day 11 postbiopsy compared with the Time Management group, with 76.2% versus 42.1% healed, χ(2)(1, n = 40) = 4.83, p = .028. Ordinal logistic regression showed more sleep in the week before wounding also predicted faster healing wounds. There were no significant group differences in changes to perceived stress, depressive symptoms, health-related behaviors, lipopolysaccharide-induced proinflammatory cytokine production, or number of doctor visits over the study period. This study extends previous research by showing that expressive writing can improve wound healing in older adults and women. Future research is needed to better understand the underlying cognitive, psychosocial, and biological mechanisms contributing to improved wound healing from these simple, yet effective, writing exercises. Australian New Zealand Clinical Trials Registry (trial number 343095).